by Cindy A. Abole, Public Relations
Sarah
Windham, 2, and her dad, Scott, practice throwing a baseball.
Her smile is infectious. Her sparkling blue eyes and delicate features have crafted the face of an angel.
But the smile and the eyes mask Sarah Windham's constant pain.
This two-and-a half year old child suffers from a unique form of juvenile rheumatoid arthritis (JRA).
Like other kids her age, Sarah's happiest playing and being active with her mom, Kathy, and other family members. Her favorite moments are spent playing catch with daddy, Scott, behind their Summerville home.
“It's important that Sarah and other children suffering from JRA keep active,” said Richard Silver, M.D., director of the Department of Medicine's Division of Rheumatology and Immunology. Active in Sarah's case will mean less stressful sports like swimming which stretches muscles and relieves stress on the body's joints.
Sarah's problems began even as she took her first steps at 12 months of age. Her mother detected a slight limp in her walk.
“It was hardly noticeable at first,” said Windham recalling how her daughter's limp would come and go. Two specific episodes confirmed the severity of Sarah's condition.
In reality, Sarah's world has been unaffected. Unlike other children and adults who are diagnosed for rheumatoid arthritis, hers is not a drastic lifestyle change.
“Actually, I'm glad she's starting out in life having to deal with this disease,” said Windham. “The disease can be more stressful to older kids (ages 7-10) who must deal with many changes in their lives. It's easy for them to feel out-of-place.”
One weekend as Sarah's parents were away on an overnight trip, Windham received a telephone call from the family's distraught babysitter. Sarah had fallen to the floor, screaming in pain and agony. She couldn't get up and she couldn't walk.
“It's bad to see your child wake up and realize she can't move,” said Windham.
Last April, Sarah, who was already 18 months old, was taken to their family physician. Her right knee was sore and swollen. Not confirming a diagnosis, their physician setup blood tests and X-rays at Summerville Medical Center. Results of these tests concluded that Sarah suffered from pauciarticular rheumatoid arthritis, a form of the JRA that affects one or two of the body's joints.
This was the beginning of the family's preparation in dealing with her arthritis.
She was referred to former pediatric orthopaedic surgeon J. David Thompson, M.D., and Silver.
Silver confirmed the arthritis and prescribed Naproxen, a non-steroidal anti-inflammatory drug, which relieves pain and swelling.
“For rheumatoid arthritis sufferers, you don't think enough people know how severe pain can be,” said Windham. “What's more painful is the knowledge that children can have this disease.”
Silver provides treatment and also manages her multidiciplinary care working with her pediatrician, pediatric orthopaedic surgeon, orthodontist and ophthalmologist. Rheumatic sufferers are susceptible to side effects including eye inflammation (chronic iridocyclitis) which occurs more in young girls with pauciarticular JRA. Arthritis can also affect the joint in a young patient's jaw known as the temporomandibular joint that causes pain and stiffness and can bring about an overbite.
Today's research yields more potent and specialized arthritic drugs. “It is fortunate that drug treatment trials are yielding new and effective drugs,” said Silver.
While the new drugs are effective, their costs are prohibitive to some people who need them. Many of the new arthritis medications available are not covered by Medicare. For example, treatment using the new drug, Enbrel, can cost as much as $12,000 per year.
This is another area that patients and their families continually struggle with, Silver said.
As the baby boom generation enters the prime years for this disease, the numbers of arthritis sufferers should yield better advocacy and improvements in health care legislation. Serving as Sarah's voice in advocating for this disease is her mother. Sarah and her mother raised money from sponsors in last fall's National Arthritis Foundation's Joint Walk at James Island County Park. On July 15, the Charleston Chapter will sponsor a Gourmet Food and Wine Fest and Silent Auction at the Charleston Embassy Suites. All proceeds will be used to support arthritis awareness and fundraising.
Early treatment also has a strong impact in containing the disease. Some juvenile rheumatoid arthritis patients have a better chance of recovery, when the disease is diagnosed early, Silver said. This illustrates the need to educate practicing physicians, residents and students in recognizing symptoms associated with arthritis.
Yet, drugs can't do everything.
For now, Sarah's best antidote is the continued support of family and friends. Their support and sentiments were proudly displayed on the T-shirts they wore during last fall's Arthritis Joint Walk. The group was known as “Sarah's Smile.”
Carolinas Chapter of the Arthritis Foundation
The Carolinas Chapter of the Arthritis Foundation sponsors many events including fitness programs, educational materials, physician referral services, fund-raising and juvenille arthritis activities.
On July 15, the chapter hosts the Gourmet Food and Wine Fest. The event is supported by area restaurants and offers participants with sampling of various cuisines.
In September, the organization will host the Third Annual Joint Walk, an event that raises public awareness of arthritis and other related diseases at James Island County Park.
Proceeds from both events will benefit education and research. For more information, call 1-800-883-8806 or <http://www.arthritis.org/offices/car>
Arthritis Facts and Myths
Myth: Arthritis only strikes the elderly.
Fact: Arthritis affects people in all age groups. Approximately 355 million people worldwide have a form of arthritis.
Myth: Arthritis isn't serious—it's only minor aches and pains.
Fact: Arthritis can start as minor aches and pains, but left undiagnosed and untreated, could become a major health problem. It is the number one cause of disability, affecting one in six, equal to 15 percent of the population or nearly 43 million people.
Myth: Nothing can be done to treat arthritis.
Fact: There are a variety of new medications introduced to the market within the past year to treat various types of arthritis from rheumatoid to Lyme disease to osteoarthritis.